Baby-Led Weaning vs Traditional Spoon-Feeding: A Systematic Review of Infant Growth, Choking Risk, and Iron Status...

Baby-led weaning (BLW) is a popular approach for introducing solid foods, supporting infant autonomy, sensory development, and family mealtimes. Despite potential benefits, concerns remain about its safety and nutritional adequacy. Further evidence is needed to clarify its effects on infant health.

This systematic review compared BLW and traditional spoon-feeding (TSF) on growth, choking risk, and iron deficiency in infants aged 6-12 months.

PubMed, CINAHL, Cochrane Library Plus, BioMed Central, and Google Scholar were searched from September 2022 to March 2023.

Titles, abstracts, and full texts were screened, and methodological quality and risk of bias were assessed using the JBI (Joanna Briggs Institute) checklist and Cochrane Handbook. Due to the limited number of studies, no meta-analysis was performed; instead, a hybrid synthesis of effect estimates and vote counting by direction was conducted, supported by box-and-whisker and harvest plots.

Four randomized clinical trials were selected from 359 publications. Dogan et al reported lower overweight prevalence with BLW (0%, 10.4 ± 0.9 kg) compared with TSF (17%, 11.1 ± 0.5 kg; P < .001), whereas Taylor et al found no difference (BLW vs TSF, 10.3% vs 6.4%; P > .05). Choking risk was similar across studies (Dogan et al: BLW [n = 2] vs TSF [n = 3]; Fangupo et al: overall, 35%; no group difference; P > .20). Hemoglobin levels also showed no significant differences (Dogan et al: BLW vs TSF, 12.28 ± 0.48 vs 12.24 ± 0.41 g/dL; Daniels et al: BLW vs TSF, 11.6 ± 0.89 vs 11.7 ± 0.84 g/dL; P > .05).

Current evidence suggests that BLW does not increase choking risk or compromise iron status compared with TSF. Its effect on growth remains limited. BLW may be considered a safe and nutritionally adequate complementary feeding method; however, these findings should be interpreted cautiously. Caregiver education on choking prevention and timely iron-rich foods is essential for safety and nutrition adequacy.

PROSPERO registration no. CRD42023402900.